Tumor persistence in high grade squamous intraepithelial lesion patients with positive surgical margin post loop electrosurgical excision procedure.

Objective: To determine the rates of persistent and recurrent tumors in patients with High Grade Squamous Intraepithelial Lesion (HSIL) who had positive surgical margin from Loop Electrosurgical Excision Procedure (LEEP).

Material And Method: Clinical and pathological data of all women who underwent LEEP procedures and revealed HSIL lesions with positive surgical margin between July 1997 and December 2004 were recorded.

Results: Histologic diagnoses of HSIL with positive surgical margin were found in 95 cases during the study period. Residual diseases were identified at ectocervical margins in 46 cases (48.4%), endocervical margin in 26 cases (27.4%), and both margins in 23 cases (24.2%). Subsequent hysterectomy was performed in 58 cases (61.0%). The remaining 37 cases (38.9%) underwent periodic follow-up with the median follow up period of 11 months (range, 1-74 months). Persistent diseases were identified in 18 of 58 hysterectomized cases but none in 37 follow-up cases. Recurrent disease was identified in only one case in the follow-up group. Overall the rates of persistent and recurrent disease were found in 18.9% and 1.1% respectively.

Conclusion: In HSIL patients with positive surgical margin from LEEP the rate of persistent disease was 18.9%, while the rate of recurrence was 1.1%.